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GTYOE AUTOMATIC METER READER
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Oid Meter Number �''���
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Replacement No. S PI�'V�� j�� �
Replacement Reading �
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Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridtey,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. t understand that the property owner
is liable for the water line from the main to the premise and all interior piumbing. (Per City code
402.06j t also hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this operation. This to include,but nat(imited to;valves,piping,walls,floars�r the curb
� stop box and service line. 1 understand I am aiso required to obtain a pe�mit prior to any work,if
necessary.
Final meter reading(old meter) � � L ` � ����
Name: Address: t'�,..a�r ` (�� �7�NI�"
Phone Number. e: �� d���l
Signature:
Witness Signature: 1' T���d�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINlSTRATION
(Ref Ord No 113,464,565,566,629,638,662, 422,988,1144, 1156, 1191}
402.05. PERMlT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anjr house
or building for which the application is made,the owner or contractor shal!be requ+red to obtain a permit for such
connection,and shaii pay a permit fee as provided in Chapter li of this Cade. After such connection has been
made,the Water and Sewer Department shall be notified. It sha(I be untawfut to cover any connecting line until an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06. REPQIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer iead at the property
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all repairs required to any water line and sewer lines
necessary for connection of the premises f�om the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, inc(uding any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the appticant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the
water senrice curb stop box for operability and at such height as will ensure that it�emains above the frnished
grade of the land or property. (Ref 638,115fi,1191j